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The PDHC-catalyzed reaction generates not only NADH, which is oxidized in the mitochondrial respiratory chain, but also acetyl-CoA, which feeds into the TCA cycle and is a precursor of acetylcholine (ACh) in cholinergic cells
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Notably, the enantiomer D-carnitine may exert hepatotoxic effects ( Table 2 Human studies on L-carnitine supplementation in MASLD
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